Gallstones risk is increased after bariatric surgery. Gastric bypass and other types of weight loss surgeries make it possible for you to lose weight rapidly, boost your confidence, and even reduce the risk of weight-related health problems such as Type 2 diabetes and heart disease.
The patients who experience gallstones after bariatric surgery ranges between 10%-38%.
If you’ve been scheduled for bariatric surgery—or if you’re considering it—it’s important to be aware that some people develop gallstones post-surgery. Unfortunately, gallstones are a common complication. The gallbladder is a small, pouch-like organ in the upper right part of your stomach that is responsible for storing a fluid called bile.
Gallstones are hardened deposits of bile that form in your gallbladder that vary in size. Some people develop just one gallstone, while others develop more than one.
Gallstone Risk by Bariatric Surgery Type:
According to this research:
- Gastric Bypass Surgery Gallstone Incidence: 34%
- Gastric Sleeve Surgery Gallstone Incidence: 28%
Gastric Sleeve had a 35% lower rate of gallstones
Gallstones after Bariatric Surgery
Gallstone formation is already common among obese individuals. That’s because when you’re overweight, you’re more likely to have higher cholesterol levels and a slower metabolism of bile.
A study published in the Journal of Metabolic and Bariatric Surgery notes that “rapid weight loss due to bariatric surgery can increase the risk of gallstone formation. This is because the liver starts to produce more cholesterol in response to the weight loss.” This study found that “the incidence of gallstone formation after bariatric surgery is 10–38% and often associated with a proportional increase in the risk of developing biliary complications.”
Even though bariatric surgery has so many benefits, it does increase your risk of gallstones—and decreasing this risk post-surgery will be in your best interest.
Risks
The risk of forming gallstones post-bariatric surgery is highest in the first two years, and especially the first six months. You may be at increased risk of developing gallstones if you were born female; if you have a close family member who has developed gallstones; and if you’re older than 40. Pre-existing gallstones before your surgery also increases your risk.
Losing weight at such a rapid pace corresponds with an increased risk of gallstones. Bariatric surgery changes bile acid circulation, making bariatric surgery patients more likely to need gallbladder surgery in order to alleviate symptoms, lessen potential complications, and improve digestion and nutrient absorption.
In some cases, surgery to remove the gallbladder (cholecystectomy) might be necessary. A study published by PubMed notes that “cholecystectomy is required in up to 15% of patients” after bariatric surgery. This studies shows that roux-en-y gastric bypass showed the highest rates, while gastric banding showed, significantly less.
If you are concerned that you’re at increased risk of developing gallstones, you should talk to your doctor about this potential complication so you can receive personalized recommendations before proceeding with the surgery.
Causes
Gallstones are caused by rapid weight loss, changes in bile composition, and stagnant bile. Losing weight quickly releases more cholesterol into your bile; excess cholesterol solidifies and forms stones within the gallbladder.
Bariatric surgery also alters the composition and flow of this fluid, creating an environment that’s more conducive to gallstone formation. Stagnant bile is an issue, too; when a portion of the small intestine is bypassed, bile can become stagnant within the gallbladder and, in turn, increase the concentration of cholesterol.
Symptoms
Symptoms of gallstones post-bariatric surgery include pain in the right upper or middle upper abdomen that lasts for at least 30 minutes. This pain can feel sharp or dull. Additional symptoms include fever, jaundice, clay-colored stools, nausea, and vomiting.
It’s also possible that you won’t have any symptoms. In this case, gallstones are often found during an x-ray, abdominal surgery, or a similar type of scheduled medical procedure.
Remedies
Medication and dietary adjustments are two potential remedies for gallstones post-bariatric surgery. Ursodeoxycholic acid is a prescription medication your doctor can prescribe to you; taking this for six months post-surgery (which corresponds to the period of time when you are losing weight most rapidly) can reduce the risk of gallstone formation.
Changing your diet can also help, especially because approximately 80% of gallstones are formed on account of high cholesterol. We recommend talking to your doctor or a registered dietician about establishing a healthy, well-balanced diet that can help you lower your cholesterol levels and reduce the risk of gallstones so you can fully focus on your weight loss journey.
